Individual provider Active NPI

Geethanjali Kuppusamy

  • Behavior Technician
  • Lynnwood, WA
National Provider Identifier
1053273060
Registry record updated Nov 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
20818 44TH Ave W Ste 190
Lynnwood, WA 98036-7745
Phone
(888) 515-1793
NPI assigned
Nov 27, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X WA Primary

Addresses

Primary practice location

20818 44TH Ave W Ste 190
Lynnwood, WA 98036-7745

Mailing address

19408 36TH Ave SE Unit B
Bothell, WA 98012-5284
Phone (206) 480-7372

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1764201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764201600000",
    "number": "1053273060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19408 36TH AVE SE UNIT B",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980125284",
            "telephone_number": "206-480-7372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20818 44TH AVE W STE 190",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980367745",
            "telephone_number": "888-515-1793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUPPUSAMY",
        "first_name": "GEETHANJALI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-11-27",
        "last_updated": "2025-11-27",
        "certification_date": "2025-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynnwood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.